Spinal Cord Injury and OSA

I want to first say that I am soooooooo excited that there is such a website and support for those of us using CPAP machines. It is so hard to talk to family and friends about using CPAPs and OSA when they are not going through it. I do have a sister who works for Fisher Paykel and is good with working on CPAPs but when I ask her certain questions, like for instance, what is rain-out and why it happens or the different types of machines that are out there because I will have to pick a machine that will be my permanent machine in a few months, once Medicare decides I am compliant, she is not sure. So whoever developed this site, you get a HUUGGGGGGGGGEEEEEEEE thank you from me .

I am newly diagnosed as having OSA and currently on both CPAP and Provigi. I am also 18 months out of being paralyzed. What I am wondering, is if anyone has heard of spinal cord injuries causing OSA. My rehabilitation doctor says that it does but of course my worker comp is saying "NO WAY." I am looking for possible documentation supporting this if so.

Thank you all for "listening" to me.

Shirley

Acutally, it appears that this is reported in the medical literature. go to http://www.pubmed.com and put ""Sleep Apnea Syndromes"[Mesh] AND "Spinal Cord Injuries"[Mesh]" (without the outside quotes) in the search box and hit search. I just got 32 hits that may be related. You'll have to look at the abstracts and find the ones that support your supposition. Then, ask doc if they really do support your argument. Give the bibliography to your WC person. You may want to order them through your local public library, too. That might cost you a couple of bucks, so be aware.

Remember, with documentation that this happens, you can appeal the WC opinion that it doesn't, if there are problems about it.

I'm a librarian and do this kind of search all the time.

macshrimp wrote:... I am newly diagnosed as having OSA and currently on both CPAP and Provigi. I am also 18 months out of being paralyzed. What I am wondering, is if anyone has heard of spinal cord injuries causing OSA. My rehabilitation doctor says that it does but of course my worker comp is saying "NO WAY."

Shirley,

Welcome!

First, did you have obstructive sleep apnea before the spinal cord injury? If not, it is a good idea to start out with an S9 Autoset instead of an S8 Vantage to see whether your apneas are mostly central or obstructive. You won't have to rely on your RT to tell you whether you are -- you can download the data yourself and check directly. Insist on the fully-data-capable S9 Autoset. If they are, you can take that information to your neurologist or sleep doc. Part of the reason why this is important is that some spinal injuries may cause centrals. Many people with CSA are often first diagnosed with OSA, only to find out differently later. Bypass all the misinformation and find out directly with an S9.

Your rehab doctor is obviously not a neurosurgeon and is partially wrong: centrals - not obstructive apneas are sometimes caused by SCI.

I googled 'spinal cord injury central apnea' and got a wealth of information. Contact your sleep doc or RT about it.
http://www.unitedspinal.org/publication ... rd-injury/

Of those SCI patients with sleep apnea, up to 25% have central sleep apnea. In the general population, only 2% of those with apnea have a purely central pattern.

Please note that I am not a doctor - just offering information I found on the web.

It pays to be very careful with narcotics and sleep aids with centrals. Good luck.

macshrimp wrote:... I am newly diagnosed as having OSA and currently on both CPAP and Provigi. I am also 18 months out of being paralyzed. ... What I am wondering, is if anyone has heard of spinal cord injuries causing OSA. My rehabilitation doctor says that it does but of course my worker comp is saying "NO WAY." ... I am looking for possible documentation supporting this if so. ...

First Shirley, welcome to the forum. Sorry that you need to be here. But making it all work is what many members to best.

I wish I could help you with your numerous issues. However, there is one thing I can do to help. I can provide some links from Google Scholar. I used the following search:

http://scholar.google.com/scholar?q=obs ... pinal+cord

Obstructive sleep apneas in relation to severity of cervical spinal cord injury.
http://www.ncbi.nlm.nih.gov/pubmed/9773446

Which includes the following summary:

... The prevalence of OSA was 15% (5/33) in this nonobese cervical cord injury study population. Nine percent of the subjects (3/33) fulfilled the criteria for obstructive sleep apnea syndrome, but daytime sleepiness or fatigue were also common in subjects without OSA. ...

Obstructive disordered breathing during sleep in patients with spinal cord injury.
http://www.ncbi.nlm.nih.gov/pubmed/2235050

This older article conclude:

Little is known about respiration and sleep in spinal cord injured (SCI) patients, and yet they frequently have complaints related to sleep. Four SCI patients with various sleep complaints were evaluated with nocturnal polysomnography. All 4 had evidence of obstructive sleep apnea (disordered breathing). These findings suggest that obstructive sleep apnea may be contributing to disruptive sleep in SCI patients and may be responsible for many of their daytime symptoms.

Factors associated with sleep apnea in men with spinal cord injury: a population-based case-control study.
http://www.ncbi.nlm.nih.gov/pubmed/11224009

And the more recent study concludes:

In this population, sleep apnea has been frequently diagnosed, particularly in tetraplegic subjects. The true prevalence is likely to be considerably higher, since this study considered only previously diagnosed cases. Sleep apnea was associated with obesity and higher neurologic level, but not ASIA Impairment Scale. Medical comorbidities were more frequent in this group, and treatment acceptance was poor with higher level motor-complete injuries. ...

Long-Term Treatment of Sleep Apnea in Persons with Spinal Cord Injury
http://journals.lww.com/ajpmr/Abstract/ ... ith.8.aspx

Which concludes:

Many spinal cord injury individuals with sleep apnea become long-term users of continuous positive airway pressure and perceive a subjective benefit from the treatment.

And so on... When talkinig with your Workers Comp folks, you can offer to provide a much longer list of articles to them. Hopefully seeing a prepared individual they will think twice.

Hope that helps.

I want to thank howkim, dreamdiver, and JohnBFisher for the WEALTH of information. I have already started to read the articles and it makes me smile the facts that support sleep apnea in spinal cord injured. This is an awesome group... Again,thank you all... I have some preparing to do for my workers comp.

Shirley

As having a Spinal cord Injury that was work related 30 years ago, I can't tell you if my own sleep apnea is related or not. But I can tell you that the WC councilors, and lawyers are truly the scum of the earth. The only time they will give in is if you can support your claims. So when you go talk to them go armed with as much of the research as you can find and don't back down to them. I lived with their lies and dirty tricks for 12 years, I am so glad that I don't have to deal with them any more.

Yes go very prepared but not like this
http://news.globaltv.com/world/Edmonton ... story.html

This was terrible. There is no way my Work comp case would ever escalate to that level. I have been originally injured for 21 years and have been through a lot with the Air Force since the beginning but I would NEVER even consider something like this. WOW!!! poor people. I am soooooo happy it ended peacefully and he gets help because it appears he really needs it.

Shirley